Evaluation of Antimicrobial Resistancein Clinical Isolates of Enterococcus spp. Obtained from Hospital Patients in Latvia

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 6; p. 850
• Main Authors: Labecka, Linda, Ķibilds, Juris, Cīrulis, Aivars, Čeirāne, Evelīna Diāna, Zeltiņa, Indra, Reinis, Aigars, Vilima, Barba, Rudzīte, Dace, Erts, Renārs, Mauliņa, Inga, Bandere, Dace, Krūmiņa, Angelika
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2024; MDPI
• Subjects: Adaptation; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial agents; antimicrobial resistance; Bacteria; Bacterial infections; Decision-making; Drug resistance; Drug resistance in microorganisms; Drug Resistance, Bacterial - genetics; enterococci; Enterococcus - drug effects; Enterococcus - genetics; Genetic engineering; Genetic testing; Genomes; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Health aspects; Hospital patients; Hospitals; Humans; Infections; Laboratories; Lacosamide; Latvia; Latvia - epidemiology; LRE; Methicillin; Microbial Sensitivity Tests; Microorganisms; Multilocus Sequence Typing; Mutation; Pathogens; Pilot Projects; resistance genes; Tetracycline; Tetracyclines; Therapeutic drug monitoring; vanB; Vancomycin-Resistant Enterococci - drug effects; Vancomycin-Resistant Enterococci - isolation & purification; VRE; Whole Genome Sequencing; Latvia; Netherlands; France; United States > US; Germany; VRE; vanB; resistance genes; antimicrobial resistance; LRE; enterococci
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60060850

: Enterococci are typically found in a healthy human gastrointestinal tract but can cause severe infections in immunocompromised patients. Such infections are treated with antibiotics. This study addresses the rising concern of antimicrobial resistance (AMR) in Enterococci, focusing on the prevalence of vancomycin-resistant enterococcus (VRE) strains. : The pilot study involved 140 Enterococci isolates collected between 2021 and 2022 from two multidisciplinary hospitals (with and without local therapeutic drug monitoring protocol of vancomycin) in Latvia. Microbiological assays and whole genome sequencing were used. AMR gene prevalence with resistance profiles were determined and the genetic relationship and outbreak evaluation were made by applying core genome multi-locus sequence typing (cgMLST). : The acquired genes and mutations were responsible for resistance against 10 antimicrobial classes, including 25.0% of isolates expressing resistance to vancomycin, predominantly of the B type. Genetic diversity among and isolates was observed and seven potential outbreak clusters were identified, three of them containing sequence types ST6, ST78 and ST80. The prevalence of vancomycin resistance was highest in the hospital without a therapeutic drug-monitoring protocol and in . Notably, a case of linezolid resistance due to a mutation was documented. : The study illustrates the concerning prevalence of multidrug-resistant Enterococci in Latvian hospitals, showcasing the rather widespread occurrence of vancomycin-resistant strains. This highlights the urgency of implementing efficient infection control mechanisms and the need for continuous VRE surveillance in Latvia to define the scope and pattern of the problem, influencing clinical decision making and planning further preventative measures.